There is a long tradition of injecting various mildly irritating substances that essentially replicate injury to initiate a natural growth sequence around the spine and in and around other joints. The prolo in prolotherapy refers to proliferation or multiplication of good, healthy connective tissue cells. This process has also been termed Regenerative Injection Therapy or RIT, non-surgical joint repair, or spine and joint regeneration. There is no single AMA insurance code for this process, as prolotherapy is a way to approach many AMA coded injections in a way that stimulates growth and repair.

We most commonly inject dextrose, a simple sugar that is approved by the FDA for this purpose in prolotherapy. Further, we add the scarce and critical vitamin B12, plus the local anesthetic procaine, the generic of Novocain. Other substances can be added.

The effect is the attraction of natural growth factors to the precise areas of injection. New tissue growth occurs in a natural cycle of 3-4 weeks. The prolotherapy process is repeated on a monthly basis until enough collagen is grown in, pain disappears, and the area stabilizes permanently.

Click on the above triangle to listen to Dr. Jonas Skardis of New Mexico Pain Management, interviewed on KSFR-FM radio on the subject of prolotherapy, PRP therapy, interventional pain management, and automobile accident care (duration: 14 minutes, 54 seconds).

What Tissues Can Prolotherapy Regrow and Repair?

We permanently re-grow

  • ligaments – bone to bone connectors
  • tendons – muscle to bone connectors
  • cartilage – cushioning, gliding surfaces within joints.

Ligaments are straps that limit bone movement within safe, pain-free boundaries. Worn, loose ligaments are themselves painful, and they cause their own referred pain. Additionally, their laxity eventually hurts surrounding structures, causing disc herniation, nerve compression, damage to tendons, damage to cartilage, and osteoarthritis.

Tendon breakdown may be felt as local pain, referred pain, or as pain and dysfunction in the muscle that the tendon connects to bone.

Cartilage and fibrocartilage (meniscus, labrum) are damaged with injury or worn down in loose ligamented, dysfunctional joints. As cartilage gets thinner, movement irritates surrounding bone edges and eventually leads to bone spurs and other degenerative bone changes.

Breakdown of these spine and joint tissues is a key source of pain.

Prolotherapy procedures that re-grow these tissues can eliminate chronic pain permanently.

We intervene with minimally invasive procedures that do not involve open surgery. We precisely inject natural substances that attract your body’s own growth factors and stem cells. This is done in some series of monthly procedures, with each procedure re-growing more and more of the damaged tissue, filling in broken fibers, gradually returning integrity and safe, pain free function to the joint or spinal region being reconstructed. It is an incremental, natural process that is, literally, gardening or farming of collagen, the substance that ligaments, tendons and cartilage are made of.

However, no medical procedure can solve all medical problems. Not every patient is a candidate. Your eligibility for our methods can be preliminarily assessed in a scheduled phone conference. If you are a candidate, then a lengthy, thorough initial evaluation and examination in our office will detail how we may be able to help.


New York Times article on prolotherapy.

Summary of prolotherapy by K. Dean Reeves, MD, Clinical Associate Professor, Physical Medicine and Rehabilitation, University of Kansas Medical Center, who has taught prolotherapy with Dr. Jonas Skardis of New Mexico Pain Management.

Sweet Relief, a somewhat more detailed, technical article in the journal Biomechanics, written by K. Dean Reeves, MD.

Ross Hauser, MD is a colleague practicing at Caring Medical in Chicago, IL. Read his prolotherapy brochure. 

Dr. Hauser is Editor of the Journal of Prolotherapy, He is the author of several books on prolotherapy Read more by Dr. Hauser at some of his websites such and

A very readable book about prolotherapy, “The Cure For Chronic Pain”, by Nancy S. Moore, PhD, RN, available as an eBookor in paperback.

?Que es la Proloterapia?


See for an extensive analysis of many of the studies on prolotherapy (PRP).

See or download Dr. Reeves’ Chapter 50, “Evidence Based Regenerative Injection Therapy (Prolotherapy) in Sports Medicine” from The Sports Medicine Resource Manual, Seldenberg P, Beutler A, editors, Saunders Publishing, 2008.

Read Dr. Jonas Skardis’ 2006 article, A Review of the Evidence for Regenerative Injection Therapy.